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SKFTCH <br />IWork to be done) <br />� <br />! s' <br />-- --- �- --- - - -. _ I aw <br />�c t <br />5�yp <br />L � e � ��'v�'� ��� �, <br />� Fic U� � <br />6G�6 <br />St�a {�� <br />8 °� <br />��w <br />�sT�,yG <br />s�r,y. <br />The undersigned owner herchy agrees to hold and save hacmless the Cily of <br />Evr.rell from any and nll da'ms for damages thal may arise because of Ihe <br />installation and maintenuncc of Ihe improvement herelo applied for and <br />furlher agroes �o remove same upon notice from Ihe City and lo replace all <br />public properiy damaged Ihereby. <br />I_3"cNAY. ��-_ SL`C <br />CiVD. �._-3C A L E � <br />.� <br />�au ;�I ._._._. _ _. ,_k- �' <br />!_.___.__-'�'—�.'.i^ �-- � <br />. �' <br />Signofure <br />� � i TF ��FCif'E/� 8_3 �"'/ <br />Dale <br />Remarks <br />i"�.. �� <br />L Oi�/ � ='h' i '.'. .� � <br />'�/ F, /" � <br />�7 I IG <br />- _ � <br />po„oeo-_P��e - '- . <br />c� yvRE%'Cc <br />"'. d <br />�'S . <br />Call Enginaering Dr,pt. 259�8803 i p�OVIDE FOR <br />2; tiaurs betore <br />constructioi� is starfed. � PhOPER qRt11NAGE <br />`� <br />� )-,_— . �. <br />��—'. __".'.M _— <br />� � �- �� � � <br />Variarce Required <br />Yes_.._........... _._...... <br />No___...._....... . ..._. <br />L � /• <br />-,-�.��' i. - . � _ <br />-� $ignafure oF Applimnt <br />� <br />/lil . .^j,�: r;.':/ ;i _ <br />Addregr' <br />�.:i �/— �G��� <br />Telephone Number <br />.'���/ � � <br />Dale <br />.$�/3, c� c� ,�~►, �l' F�� f>f <br />Fee v✓�� <br />DEPT. <br />��itiWaler �,�,.�.�._ -i-�-i <br />, <br />i � Slreet `,t�-r: -n-ti �/.'� tic...: ti�,_ <br />� Communications ��� =rf �'-A �` <br />�� Traffic r�U"� �� "�' <br />l Planning /`"/f�.4' <br />?�--�_.. __ ..._.. <br />�'NOTE --- ------_ _ -. <br />CI-IECK WITH WATF_R <br />�EPT. FOR VJ.4TER LINE 1 <br />� L�CA7IUNS BEfORE EXCAVATIONJ <br />/ <br />�//: <br />